Influence of participating in religious activity on smoking behavior: A Baltimore Epidemiologic Catchment Area (ECA) study

Background: Participation in religious activity may be protective against tobacco use and tobacco related health problems. This study investigated the relationship between reported smoking status and participation in religious activity, after controlling for potential confounders. Methods: Participants (N=944) were sampled from wave four of the Baltimore Epidemiologic Catchment Area (ECA) Survey administered from 2004-2005. Logistic regression assessed the relationship between religious activity and smoking status since wave three of the survey (1993-1994) after controlling for potential confounders. Results: Forty-two percent (N=395) of the participants reported smoking, of whom 60% (N=236) were female. Individuals who participated in religious activities once per week were 52% less likely to report smoking as compared to those who never participated in religious activity (AOR: 0.48; 95% CI 0.31, 0.75). Individuals who participated in religious activities more than once per week as compared to never were 58% less likely to report smoking (AOR: 0.42; 95% CI 0.25, 0.70). When stratified by gender, the inverse relationship between smoking and participating in religious activity remained significant for females, but not for males. Implications for Practice: This study suggests that religious activity and smoking behaviors are inversely related. Churches remain a pillar in many communities and may serve as an additional platform for smoking cessation. Additional research into the directionality of this relationship and potential gender differences is warranted to inform how community based interventions are tailored in the future.